How much rates vary
Facilitymedian $102 · 10th to 90th $83 to $102Professionalmedian $98 · 10th to 90th $83 to $138
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $79.43 Median $85.11 Typical High $114.82 | Facility | None | $79.43 | $85.11 | $114.82 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $93.33 Typical High $114.82 | Professional | None | $79.43 | $93.33 | $114.82 |
Ambetter Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $114.82 | Professional | None | $102.33 | $102.33 | $114.82 |
BCBS Texas Setting Professional Modifier None Typical Low $93.33 Median $104.71 Typical High $128.82 | Professional | None | $93.33 | $104.71 | $128.82 |
Christus Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $125.89 Typical High $181.97 | Professional | None | $79.43 | $125.89 | $181.97 |
Lucent Health Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
Moda Health Setting Facility Modifier None Typical Low $79.43 Median $85.11 Typical High $147.91 | Facility | None | $79.43 | $85.11 | $147.91 |
Moda Health Setting Professional Modifier None Typical Low $79.43 Median $93.33 Typical High $114.82 | Professional | None | $79.43 | $93.33 | $114.82 |
Molina Setting Professional Modifier None Typical Low $64.57 Median $131.83 Typical High $141.25 | Professional | None | $64.57 | $131.83 | $141.25 |
Providence Setting Facility Modifier None Typical Low $102.33 Median $128.82 Typical High $162.18 | Facility | None | $102.33 | $128.82 | $162.18 |
Providence Setting Professional Modifier None Typical Low $87.10 Median $125.89 Typical High $181.97 | Professional | None | $87.10 | $125.89 | $181.97 |
United Setting Professional Modifier None Typical Low $81.28 Median $100.00 Typical High $131.83 | Professional | None | $81.28 | $100.00 | $131.83 |
Wellpoint Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
18 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $39.81 Median $41.69 Typical High $42.66 | Facility | 52 · Reduced service | $39.81 | $41.69 | $42.66 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.02 Median $12.59 Typical High $12.88 | Facility | 55 · Aftercare only | $12.02 | $12.59 | $12.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.94 Median $8.32 Typical High $8.51 | Facility | 56 · Pre-op care only | $7.94 | $8.32 | $8.51 |
Aetna Setting Facility Modifier AF · Specialist physician Typical Low $109.65 Median $114.82 Typical High $114.82 | Facility | AF · Specialist physician | $109.65 | $114.82 | $114.82 |
Aetna Setting Facility Modifier HO · Master's level Typical Low $83.18 Median $85.11 Typical High $87.10 | Facility | HO · Master's level | $83.18 | $85.11 | $87.10 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $93.33 Median $97.72 Typical High $97.72 | Facility | TD · Registered nurse | $93.33 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $41.69 Typical High $42.66 | Professional | 52 · Reduced service | $39.81 | $41.69 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $12.59 Typical High $12.88 | Professional | 55 · Aftercare only | $12.02 | $12.59 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $8.32 Typical High $8.51 | Professional | 56 · Pre-op care only | $7.94 | $8.32 | $8.51 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $39.81 Median $41.69 Typical High $42.66 | Facility | 52 · Reduced service | $39.81 | $41.69 | $42.66 |
Moda Health Setting Facility Modifier 55 · Aftercare only Typical Low $12.02 Median $12.59 Typical High $12.88 | Facility | 55 · Aftercare only | $12.02 | $12.59 | $12.88 |
Moda Health Setting Facility Modifier 56 · Pre-op care only Typical Low $7.94 Median $8.32 Typical High $8.51 | Facility | 56 · Pre-op care only | $7.94 | $8.32 | $8.51 |
Moda Health Setting Facility Modifier AF · Specialist physician Typical Low $109.65 Median $114.82 Typical High $114.82 | Facility | AF · Specialist physician | $109.65 | $114.82 | $114.82 |
Moda Health Setting Facility Modifier HO · Master's level Typical Low $83.18 Median $85.11 Typical High $87.10 | Facility | HO · Master's level | $83.18 | $85.11 | $87.10 |
Moda Health Setting Facility Modifier TD · Registered nurse Typical Low $93.33 Median $97.72 Typical High $97.72 | Facility | TD · Registered nurse | $93.33 | $97.72 | $97.72 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $41.69 Typical High $44.67 | Professional | 52 · Reduced service | $39.81 | $41.69 | $44.67 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $12.59 Typical High $13.18 | Professional | 55 · Aftercare only | $12.02 | $12.59 | $13.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $8.32 Typical High $8.91 | Professional | 56 · Pre-op care only | $7.94 | $8.32 | $8.91 |
Where Texas sits
The same service costs 2.9 times more in Alaska than in Ohio. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Texas· 37th of 51
$102
AK $224OH $77.62
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.